What question did this study set out to answer?

To assess the effects of SGLT2 inhibitors versus placebo on clinical outcomes in patients with heart failure and reduced ejection fraction, with or without diabetes.

October 10, 2023Experimental and Therapeutic MedicineOpen Access

SGLT2i‑treated heart failure patients with a reduced ejection fraction: A meta‑analysis

Q: What are the key findings of this study?

SGLT2 inhibitors significantly reduced the risk of hospitalization for heart failure or cardiovascular death (OR 0.72) compared to placebo in patients with heart failure and a reduced ejection fraction.

Q: What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Heart failure with reduced ejection fraction (HFrEF) (n=34108). Intervention: SGLT2 inhibitors (empagliflozin and dapagliflozin) vs. Placebo. Primary outcome: Hospitalization for heart failure or cardiovascular death (OR 0.72, 95% CI 0.67-0.78, p=<0.0001).

Q: What does this research mean for the field?

SGLT2 inhibitors significantly reduce the risk of hospitalization for heart failure or cardiovascular death (OR 0.72), as well as all-cause mortality, compared to placebo in patients with heart failure and a reduced ejection fraction, regardless of diabetes status. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

SGLT2 inhibitors cut CV death or HF hospitalization ~28% vs placebo in HFrEF.

OR 0.72
95% CI 0.67-0.78
P<0.0001
n=34,108

Why the study?

The study was conducted to investigate the effects of SGLT2 inhibitors in patients with heart failure and reduced ejection fraction, with or without diabetes.

Does SGLT2i reduce hospitalization for HF, cardiovascular death, and all-cause mortality in patients with HFrEF with or without diabetes?

Population

Patients with heart failure and reduced ejection fraction, with or without diabetes, across 5 RCTs

Comparison

SGLT2 inhibitors vs placebo

Design

Systematic review and meta-analysis of RCTs

Authors

QYQiang YeJiangsu University KZKelan ZhaAffiliated Hospital of Southwest Medical University

Discussion

Member takes

Implication

Reduces HF hospitalization or CV death risk in HFrEF; confirms benefit regardless of diabetes status.

Key Points

To assess the effects of SGLT2 inhibitors versus placebo on clinical outcomes in patients with heart failure and reduced ejection fraction, with or without diabetes.
Systematic review and meta-analysis of 5 randomized controlled trials identified from PubMed, Web of Science, and EMBASE from inception through July 2021.
Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated using fixed-effects or random-effects models alongside leave-one-out sensitivity analyses.
SGLT2 inhibitors significantly reduced the composite risk of HF hospitalization or cardiovascular death (OR=0.72, 95% CI 0.67–0.78, P<0.0001; I²=0.0%) and HF hospitalization alone (OR=0.69, 95% CI 0.63–0.75, P<0.0001; I²=0.0%).
SGLT2 inhibitor therapy significantly decreased cardiovascular mortality (OR=0.84, 95% CI 0.77–0.93, P<0.0001; I²=0.0%) and all-cause mortality (OR=0.79, 95% CI 0.71–0.89, P<0.0001; I²=3.3%) compared to placebo.

Study Design

Type

Meta-Analysis (n=34,108)

Structured PICO

Does SGLT2i reduce hospitalization for HF, cardiovascular death, and all-cause mortality in patients with HFrEF with or without diabetes?

Population

34,108 patients with heart failure and reduced ejection fraction (LVEF <40%), with or without diabetes, pooled from 5 randomized controlled trials.

Intervention

SGLT2 inhibitors (empagliflozin or dapagliflozin, 10 mg daily) for >12 months.

Comparator

Placebo.

Outcome

Hospitalization for HF/cardiovascular death, cardiovascular death, hospitalization for HF, and all-cause mortality.composite

Main Result

Effect estimate: OR 0.72 (95% CI 0.67-0.78)

p-value: p=<0.0001

SGLT2 inhibitors significantly reduce the risk of heart failure hospitalization, cardiovascular death, and all-cause mortality in patients with HFrEF, regardless of diabetes status.

Limitations

Studies using only two SGLT2i (dapagliflozin and empagliflozin) were included.
The number of RCTs included was too small (5 studies), preventing subgroup analysis of the two different SGLT2i.
Studies using only two SGLT2i (dapagliflozin and empagliflozin) were included
The number of RCTs included was too small to perform subgroup analysis of two different SGLT2i

Cite This Study

Ye et al. (2023) conducted a meta-analysis in Heart failure with reduced ejection fraction (HFrEF) (n=34,108). SGLT2 inhibitors (empagliflozin and dapagliflozin) vs. Placebo was evaluated on Hospitalization for heart failure or cardiovascular death (OR 0.72, 95% CI 0.67-0.78, p=<0.0001). SGLT2 inhibitors significantly reduced the risk of hospitalization for heart failure or cardiovascular death (OR 0.72) compared to placebo in patients with heart failure and a reduced ejection fraction.

synapsesocial.com/papers/6a153048d64fa333899f584d https://doi.org/10.3892/etm.2023.12248

Topics

SGLT2 inhibitors in heart failure

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SGLT2i‑treated heart failure patients with a reduced ejection fraction: A meta‑analysis

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

SGLT2i‑treated heart failure patients with a reduced ejection fraction: A meta‑analysis

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

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